A comparision of short and long reading passages in symptomatic vs. asymptomatic subjects.

BACKGROUND: The visual system is necessary for reading. Understanding the mechanics of eye movements during reading can give insight into the reading process. The ReadAlyzer is an electronic recording system that measures eye movements while reading. Long passages on the ReadAlyzer of 800 words have recently been introduced as a tool to assess the efficiency of reading eye movements. Previously, short passages of 100 words have been used exclusively. This project was designed to determine if passage length influences the quality of reading eye movements; METHODS: Optometry students (N = 40) at Southern College of Optometry were separated into 2 equal groups (symptomatic vs. asymptomatic) based on the College of Optometrists in Vision Development Quality of Life questionnaire score. Each subject then performed two reading passage recordings with the ReadAlyzer: one short, one long. The order of the passages was alternated to reduce fatigue effects. Data were collected based on the ratio of fixations-to-regressions; RESULTS: A multivariate analysis of variance indicated that the difference between short and long paragraphs for the symptomatic and asymptomatic groups combined was significant (P = 0.001) but was not significant for the symptomatic group vs. the asymptomatic group ( P = 0. 651) . Post-hoc comparisons using estimated marginal means indicated for asymptomatic, short vs. long, P = .036 and for symptomatic, short vs. long, P = 0.008. Additionally, for short length, symptomatic vs. asymptomatic, P = 0.242 and for long length, symptomatic vs. asymptomatic, P = 0.176; CONCLUSION: This information indicates that both symptomatic and asymptomatic patients will have more difficulty on longer reading passages. This finding calls into question the use of shorter length reading tests to determine a diagnosis of ocular motor dysfunction and other visual efficiency problems.

The College of Optometrists in Vision Development checklist related to vision function: expert opinions.

BACKGROUND: The College of Optometrists in Vision Development (COVD) Quality of Life (QOL) checklist has been reported to have good test-retest reliability. Symptom scores measured by this instrument have demonstrated validity by showing a significantly improved score with optometric vision therapy. The COVD-QOL scores inversely correlate with academic achievement on standardized tests, and the instrument has been shown to differentiate between attention deficit disorder/attention deficit hyperactivity disorder children. The individual items on the COVD-QOL have not, however, been studied as to their relationship to general areas of vision investigated by the optometric examination. METHODS: To ascertain if COVD-QOL symptoms can be related to areas of vision function, a group of 28 practicing optometrists from all parts of the United States were surveyed for their opinions. The venue was a conference whose theme was vision therapy and the functional use of lenses and prisms. All the participants offered vision therapy within their practices. They were asked to rank 5 general areas of vision skills (orientation, ocular motor, binocular, accommodation, and perception) as to whether these areas might relate to individual symptoms contained in the COVD-QOL. A frequency distribution was developed based on these results. A Likert scale was also used to compare the specific symptom (COVD-QOL item) to the opinion of the clinicians who participated. A Likert scale assumes equal separation among the 5 levels of symptom severity. RESULTS: Thirteen items were found to have high agreement, and 11 were considered in moderate agreement when the opinions of these experts were compared. Each of the 5 areas of vision had at least 1 item with high or moderate agreement. CONCLUSIONS: Expert opinion is a reasonable first step in investigating symptoms as they relate to signs, but more study is needed to verify if these subjective relationships actually exist.

The effects of cell phone use on peripheral vision.

BACKGROUND: Cell phone use and its distraction on a person's cognitive ability to assess information from a complex visual task, such as driving, have been demonstrated. Does talking on a cell phone cause a decrease in visual field awareness? METHODS: Goldmann visual fields were measured twice, with and without a cell phone conversation taking place. A College of Optometrists in Vision Development quality-of-life questionnaire (COVD-QOL) was administered to identify visually related symptoms. RESULTS: Forty subjects (21 women and 19 men) aged 22 to 71 (mean age, 39.9 years) participated in the study. Significant overall constriction between the visual field isopters plotted during cell phone use, when compared with no cell phone use, was shown. Analysis of individuals with visual symptoms (COVD-QOL score of 20 or greater), were compared with those without visual symptoms (<20 on COVD-QOL). Both groups showed significant visual field constriction with cell phone use. The percentage of constriction was not significantly different between the 2 groups. Subjects with visual symptoms initially measured a more constricted visual field than did the nonvisual symptom group. The percentage of constriction of the nonvisual symptom group, while using a cell phone, was almost identical to the visual field constriction of the visual symptom group without cell phone use. CONCLUSION: Cell phone conversations tend to artificially constrict the peripheral awareness as measured by a visual field. This suggests that cell phone use while driving can decrease the perceptual visual field, making the driver less aware of the surroundings and more susceptible to accident.

Near point of convergence norms measured in elementary school children.

PURPOSE: Convergence insufficiency (CI) is the most prevalent of binocular dysfunctions. A prime finding in the diagnosis of CI is the near point of convergence (NPC). METHODS: The NPC was measured six different times on the same 539 children, once in the fall and once in the spring, over the course of 3 years. At each evaluation, the NPC was performed three consecutive times. An accommodative target was used in the testing and the breaks and recoveries were carefully measured and recorded to the nearest centimeter. Normative data for the break and recovery finding were calculated. RESULTS: We found that the NPC measures receded significantly over three consecutive tests. The recession was not considered clinically significant for either the break or recovery measures. When various break and recovery findings were compared with reported symptoms, it was discovered that one of the break findings statistically predicted the symptomatic group from the asymptomatic group. CONCLUSIONS: The NPC break and recovery does not change appreciably with multiple administrations of the test in the same test period. The criteria for a NPC break score to differentiate the more symptomatic and less symptomatic, elementary school children on the average should be 5 cm, or less. The NPC break and recovery criteria described here should be tentatively used as one of the benchmarks in the diagnosis of convergence insufficiency.

The association between vision quality of life and academics as measured by the College of Optometrists in Vision Development Quality of Life questionnaire.

BACKGROUND: Undetected visual problems are one of the causes of academic difficulties in the classroom. An easily administered screening device that identifies children who are likely to do poorly in school because of vision problems would be a valuable tool. The screening should be able to be performed by a classroom teacher or aide. The objective of this study was to determine if there was an association between vision-related quality-of-life factors (19-item College of Optometrists in Vision Development Quality of Life [COVD-QOL] questionnaire checklist) and academic performance. A secondary objective was to determine whether student and parent responses to the questionnaire would be similar. METHODS: Ninety-one parents or guardians and their children, attending the third, fifth, and seventh grades in a public school participated in this study. Both the parent or guardian and student independently completed the checklist. The scores of both groups were compared with the Stanford IX test scores for total reading, total math, total spelling, and total battery scores of the Stanford IX. The parent or guardian and student scores were compared to evaluate the agreement (intergroup reliability). RESULTS: Parent or guardian and student checklist scores were compared. The Wilcoxon Signed Rank test showed that the mean scores for the parent or guardian were significantly lower than for third grade students and also for the total sample. Visual symptoms were found to be inversely correlated to academic performance; the lower the academic score, the more symptoms were reported. Symptoms reported by third grade students and their parents tended to be more highly correlated with academic scores. In general, symptoms reported by the parent were more highly correlated with academic score than the symptoms reported by the student. CONCLUSION: The COVD-QOL questionnaire is a cost-effective, quick, and easy tool that may be used in school screening to identify possible visual symptoms that are correlated to academic performance.